Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15) IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Husband,and , Wife.FINAL JUDGMENT FOR SUPPORT UNCONNECTED WITH DISSOLUTION OF
MARRIAGE WITH DEPENDENT OR MINOR CHILD(REN)This cause came before this Court on a Petition for Support Unconnected with Dissolution of Marriage
under section 61.09, Florida Statutes. The Court, having reviewed the file and heard the testimony,
makes these findings of fact and reaches these conclusions of law:1. The Court has jurisdiction over the subject matter and the parties.2. The following child(ren) are common to the parties:Name Birth dateSECTION I. ALIMONY1. _____The Court denies the request(s) for alimony. OR2._____The Court finds that there is a need for alimony and that _____Husband _____Wife
has/had the ability to support his/her spouse and has failed to do so. ____Husband
____Wife(hereinafter Obligor) has the present ability to pay alimony as follows: {Indicate all that apply}a._____ Permanent Periodic. 1.The court finds that no other form of alimony is fair and reasonable under the
circumstances of the parties.
Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15)2.As a marriage of {choose only one}:_____Long Duration (17 years or greater) alimony is appropriate upon consideration
of all relevant factors;_____Moderate Duration ( greater than 7 years but less than 17) alimony is
appropriate based upon clear and convincing evidence after consideration of all
relevant factors; or_____Short Duration (less than 7 years) alimony is appropriate based upon the
following exceptional circumstances:_______________________________________________________________________________________________________________________________________________________________. 3. Obligor shall pay permanent periodic alimony to Obligee in the amount of $ ______
per month, payable _____ in accordance with Obligor’s employer’s payroll cycle, and in
any event, at least once a month or _____ other: {explain}________________________
beginning {date} _______________. This alimony shall continue until modified by court
order, the death of either party, or remarriage of Obligee, whichever occurs first. The alimony may be modified or terminated based upon either a substantial change
in circumstances or the existence of a supportive relationship in accordance with
section 61.14, Florida Statutes. b._____Bridge-the-Gap. Obligor shall pay bridge-the-gap alimony to Obligee in the amount of
$___________ per month, payable _____ in accordance with Obligor’s employer’s payroll cycle,
and in any event, at least once a month, or _____ other: {explain}_____________________ ___beginning {date}___________ _________ and continuing until {date}________________ ______{a period not to exceed two (2) years}, death of either party or remarriage of Obligee.c._____Rehabilitative. Obligor shall pay rehabilitative alimony to Obligee in the amount of
$ per month, payable _____ in accordance with Obligor’s employer’s payroll cycle,
and in any event, at least once a month, or _____ other {explain} _________________________
beginning {date} ____. This rehabilitative alimony shall continue until modified
by court order, the death of either party or until {date/event} _________________________ ,
whichever occurs first. The rehabilitative plan presented demonstrated the following: ________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________. d.__ ___Durational. Obligor shall pay durational alimony to Obligee in the amount of $________ per month, payable _____ in accordance with Obligor’s employer’s payroll cycle, and in any event, at least once a month, or _____ other: {explain}______________________________ _ beginning
{date}_______________________ and terminating on {date}_________________________, the
death of either party, remarriage of Obligee or until modified by court order in accordance with
section 61.08(7),Florida Statutes; whichever occurs first.
Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15)e._____ Lump Sum. Obligor shall pay lump sum alimony to Obligee in the amount of $_________
which shall be paid as follows:______________________________________________________. f. _____ Retroactive. Obligor shall pay retroactive alimony in the amount of $ _____________ for the period of {date} , through {date} , which shall be
paid pursuant to paragraph 4 below.
3. Reasons for _____ Awarding _____ Denying Alimony. The Court has considered all of the
following in awarding/denying alimony:a. The standard of living established during the marriage;b. The duration of the marriage;c. The age and the physical and emotional condition of each party; d. The financial resources of each party, including the nonmarital and the marital assets and
liabilities distributed to each; e. The earning capacities, educational levels, vocational skills, and employability of the parties
and, when applicable, the time necessary for either party to acquire sufficient education or
training to enable such party to find appropriate employment;f. The contribution of each party to the marriage, including, but not limited to, services
rendered in homemaking, child care, education, and career building of the other party; g. The responsibilities each party will have with regard to any minor children they have in
common;h. The tax treatment and consequences to both parties of any alimony award, including the
designation of all or a portion of the payment as a nontaxable, nondeductible payment;i. All sources of income available to either party, including income available to either party
through investments of any asset held by that party; and j. Any other factor necessary to do equity and justice between the parties: {Explain} ______ Please indicate here if additional pages are attached.4. Arrearage/Retroactive Alimony. a._____There is no alimony arrearage at the time of this Final Judgment.ORb._____ Respondent shall pay to Petitioner the alimony arrearage of: $ for retroactive alimony, as of {date} . $ for previously ordered unpaid alimony, as of {date} . The total of $ in alimony arrearage shall be repaid in the amount of $
per month, payable _____ in accordance with Obligor’ s employer’s payroll cycle, and in any
event, at least once a month _____ other {explain} __________________________
beginning {date} __________, until paid in full including statutory interest.
Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15)5._____ Life Insurance (to secure payment of support). To secure the alimony obligations set
forth in this judgment, Obligor shall maintain life insurance on his/her life naming Obligee as
the sole irrevocable beneficiary, so long as reasonably available. This insurance shall be in the
amount of at least $__________ and shall remain in effect until the obligation for alimony
terminates.
6. _____ Other provisions relating to alimony including any tax treatment and consequences: a.The award of alimony _____ does not _____ does leave the Obligor with significantly
less net income than the net income of the recipient/Obligee. If yes, the court finds the
following exceptional circumstances:_________________________________________ _______________________________________________________________________ ________________________________________________________________________.b.Other:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.SECTION II. CHILD SUPPORT1.The Court finds that there is a need for child support and that the _____ Mother _____ Father
(hereinafter Obligor) has the present ability to pay child support. The amounts in the Child
Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e), filed by
the _____ Mother _____Father are correct OR the Court makes the following findings: The Mother’s net monthly income is $ ___________,(Child Support Guidelines _ %). The Father’s net monthly income is $ ____, (Child Support Guidelines _____%). Monthly child care costs are $ . Monthly health/dental insurance costs are $ .2.Amount. Child support established at the rate of $____________ per month for the______children {total
number of parties’ minor or dependent children} shall be paid commencing _______________
{month, day, year} and terminating ___________________ {month, day, year}. Child support
shall be paid in the amount of $________ per ______________{week, month, other} which is
consistent with the Obligor’s current payroll cycle. Upon the termination of the obligation of child support for one of the parties’ children, child
support in the amount of $__________for the remaining_________children {total number of
remaining children} shall be paid commencing ____________________________{month, day,
year} and terminating________________________________ {month, day, year}. This child
support shall be paid in the amount of $_______ _per_______________ {week, month, other}
consistent with the Obligor’s current payroll cycle.
Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15){Insert schedule for the child support obligation, including the amount, and commencement
and termination dates, for the remaining minor or dependent children, which shall be payable
as the obligation for each child ceases. Please indicate whether the schedule _____appears
below or _____ is attached as part of this form.}____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.The Obligor shall pay child support until all of the minor or dependent children: reach the age of
18; become emancipated, marry, join the armed services, die, or become self-supporting; or
until further order of the court or agreement of the parties. The child support obligation shall
continue beyond the age of 18 and until high school graduation for any child who is dependent
in fact, between the ages of 18 and 19, and is still in high school, performing in good faith with a
reasonable expectation of graduation before the age of 19. If the child support ordered deviates from the guidelines by more than 5%, the factual findings
which support that deviation are: . 3.Arrearage/Retroactive Child Support. a._____ There is no child support arrearage at the time of this Final Judgment. ORb._____ The _____ Mother _____ Father shall pay to the other party the child support for
previously ordered unpaid child support, as of {date} ____________________________. The total of $ __________ of child support arrearage shall be repaid in the amount of
$ ____ per month, payable _____ in accordance with Obligor’s employer’s payroll
cycle, and in any event, at least once a month _____ other {explain} __________________
beginning {date} _________, until paid in full including statutory interest.4. Insurance. {Indicate all that apply}a._____ Health/Dental Insurance. _____ Mother _____ Father shall be required to
maintain _____ health and/or _____dental insurance for the parties’ minor child(ren), so
long as it is reasonable in cost and accessible to the child(ren). The party providing insurance
shall be required to convey insurance cards demonstrating said insurance to the other party. OR _____ Health _____ Dental insurance is either not reasonable in cost or accessible to the
children at this time.
Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15)b._____ Reasonable and necessary uninsured medical/dental/prescription drug costs for the
minor child(ren) shall be assessed as follows:_____ Shared equally by both parents._____ Prorated according to the child support guideline percentages._____ Other {explain}: As to these uninsured medical/dental/prescription drug expenses, the party who incurs the
expense shall submit a request for reimbursement to the other party within 30 days, and
the other party, within 30 days of receipt, shall submit the applicable reimbursement for
that expense, according to the schedule of reimbursement set out in this paragraph.5._____ Life Insurance (to secure payment of support). To secure the child support obligations in
this judgment, _____ Mother _____ Father _____ Each party shall maintain life insurance, in an
amount of at least $ , on _____ his life _____ her life _____ his/her life naming the
_____ minor child(ren) as the beneficiary(ies) OR naming _____ Mother _____ Father
_____ other {name}___________________________________as Trustee for the minor
child(ren). The obligation to maintain the life insurance coverage shall continue until the
youngest child turns 18, becomes emancipated, marries, joins the armed services, dies, or
becomes self-supporting.6.IRS Income Tax Exemption(s). The assignment of any tax exemption(s) for the child(ren) shall
be as follows: ___________________________________________________________________ . Further, each party shall execute any and all IRS forms necessary to effectuate the provisions of
this paragraph.7. Other provisions relating to child support: ___________________________________________SECTION III. METHOD OF PAYMENTObligor shall pay court-ordered child support/alimony and arrears, if any, as follows:1. Place of Payment. a. _____ Obligor shall pay court-ordered support directly to either the State Disbursement Unit
or the central depository, as required by statute, along with any fee required by statute. b. _____ Both parties have requested and the court finds that it is in the best interests of the
child(ren) that support payments need not be directed through either the State
Disbursement Unit or the central depository at this time; however, either party may
subsequently apply ,pursuant to section 61.08 or 61.13, Florida Statutes, to require
payments through either the State Disbursement Unit or the central depository.
Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15)2.Income Deduction. a._____ Immediate. Obligor shall pay through income deduction, pursuant to a separate
Income Deduction Order which shall be effective immediately. Obligor is individually
responsible for paying this support obligation until all of said support is deducted from
Obligor’s income. Until support payments are deducted from Obligor’s paycheck, Obligor is
responsible for making timely payments directly to the State Disbursement Unit or the
Obligee, as previously set forth in this order.b._____ Deferred. Income deduction is ordered this day, but it shall not be effective until a
delinquency of $ ______, or, if not specified, an amount equal to one month ’s
obligation occurs. Income deduction is not being implemented immediately based on the
following findings: Income deduction is not in the best interests of the child(ren) because:
{explain} ___________________________________________________________________
, AND _____ there is proof of timely payment of a previously ordered obligation without an
Income Deduction Order in cases of modification, AND _____ there is an agreement by the Obligor to advise the Title IV-D agency, clerk of court,
and Obligee of any change in Payor and/or health insurance OR _____there is a signed written agreement providing an alternative arrangement between
the Obligor and the Obligee and, at the option of the IV-D agency, by the IV-D agency in IV-D
cases in which there is an assignment of support rights to the state, reviewed and entered in
the record by the court.3. Bonus/one-time payments. _____ All _____% _____ No income paid in the form of a bonus or
other similar one-time payment, up to the amount of any arrearage or the remaining balance
thereof owed pursuant to this order, shall be forwarded to the Obligee pursuant to the payment
method prescribed above.
4.Other provisions relating to method of payment. _____________________________________SECTION IV. ATTORNEY’S FEES, COSTS, AND SUIT MONEY1._____ Husband’s _____ Wife’s request(s) for attorney’s fees, costs, and suit money is (are)
denied because: ________________________________________________________________ . 2._____ The Court finds there is a need for and an ability to pay attorney’s fees, costs, and suit
money. _____Husband _____ Wife is hereby ordered to pay to the other party $ _____
in attorney’s fees, and $ _____ in costs. The Court further finds that the attorney’s fees
awarded are based on the reasonable rate of $____________per hour and ___ reasonable
hours. Other provisions relating to attorney’s fees, costs, and suit money are as follows:
______________________________________________________________________________
.
Florida Supreme Court Approved Family Law Form 12.994(a), Final Judgment for Support Unconnected with
Dissolution of Marriage with Dependent or Minor Child(ren) (03/15)SECTION V. OTHER PROVISIONS1.Other Provisions: _______________________________________________________________ . 2.The Court reserves jurisdiction to modify and enforce this Final Judgment.DONE AND ORDERED at _____, Florida, on _______________________ .CIRCUIT JUDGEI certify that a copy of the {name of document(s)} _________________________________________
was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties and any
entities listed below on {date}_______________________. by ______________________________________{clerk of court or designee} _____Husband (or his attorney)_____Wife (or her attorney)_____Central Depository_____State Disbursement Unit_____Other: